Objective To observe the effect of intravenous thrombolysis on TIMI flow of acute myocardial infarction(AMI).Methods A total of 229 patients with AMI analysed retrospectively were divided into two groups:intravenous thrombolysis(IVT)group(n=131)and primary percutaneous coronary intervention(PCI)group(n=98).The treatment time and acute-phase outcomes were compared between the IVT group and the PCI group;104 patients in the IVT group received rescued or delayed PCI(IVT+PCI);TIMI flow was analysed between the IVT+PCI group and the PCI group.Results The time from the emergency room door to initiation of treatment was shorter in the IVT group than in the PCI group(67.79 min vs 134.54 min,P=0.000).At the initial coronary angiography,TIMI 3 flow and TIMI 2+3 flow were higher in the IVT+PCI group than in the PCI group(40.4% vs 24.5%,P=0.016;63.5% vs 36.7%,P=0.000 respectively).There was no significant difference between the IVT group and the PCI group in terms of major adverse cardiac events(MACE).Conclusion IVT as an initial treatment for AMI might achieve earlier reperfusion at TIMI≥2 flow,and it should be popularized in the primary hospitals.

In order to study the effect of chronic noise exposure on auditory center, seven guinea pigs were .exposured to 105 dB A noise 8h daily for 45 d. Then the animals were killed by decapitation. The superior olive and inferior colliculus were taken immediately to make the samples of electron microscope. The mitochondria swelling, membrane rupture, cristae breaking, ballooning degeneration were found. The rough surfaced endoplasmic reticulum was swollen and expanded. The lysosome and secondary lysosome were increased. The cell interstitial edema and synaptic besicle decrease were observed. The nuclear chromatid was decreased and nucleolus was kept to the side. The laminae of neurilemma of nerve fibers were dissociated, swollen and broken. The results indicate that the ultrastructure, neural cells and fibers in the auditory center are damaged by chronic noise exposure and most of these damages are irreversible.

The effects of different doses of r-ray on cochlea are reported in this paper. Significant hearing loss and severe cochlea hair cells injury were found while radiation dose was more than 80 Gy. With 40 Gy to 60 Gy, slight hearing loss, but cochlea hair cells and support cells impairment were observed. With 20 Gy, no hearing loss and no hair cell damage were found. The results indicated that the damage increases with a dose of radiation and there is a delay effect of radiation on cochles.

14mm.Results Group thick cycles had significantly lower implantation and pregnancy rates compared with group normal cycles(9.1% versus 13.5% and 18.8% versus 27.0%,respectively).Group thick cycles had significantly higher miscarriage rates compared with group normal cycles(50.0% versus 19.0%,respectively).Conclusion Increased endometrial thickness is associated with the decreased implantation or pregnancy rates and the increased miscarriage rates in IVF-ET.

Objective To investigate and analyze the attitudes of higher vocational nursing students toward death and the related effect factors.Methods Totally 324 nursing students in a higher vocational school in Shaanxi province were investigated with death attitude profile-revised scale.Contents of investigation included physical and mental health status,family members' attitude towards death,family form and ranking,religion,presence of suicidal thoughts,exposure to mass media reports about death,reading books about death,death fear,death escape,natural acceptance,approach acceptance,avoidance acceptance,etc.SPSS 16.0 was used for data entry and statistic analysis,mean and standard deviation for statistical description,t test and variance analysis for statistical inference.Results ①Higher vocational nursing students got the highest average score (3.93 ± 0.55) in the dimension of natural acceptance.②In the dimension of avoidance acceptance,the scores of nursing students with excellent and good physical and mental health were significantly lower than those of students with general physical and mental health (F=4.80,P=0.009) ; the scores of nursing students in single parent family were significantly higher than those of students in other family forms (F=4.59,P=0.004) ; the scores of nursing students with suicidal thoughts were significantly higher than those of students without (t=-4.77,P=0.000).In the dimension of death avoidance,the scores of nursing students whose family discussed death openly were significantly lower than those of students whose family never done so (F=6.88,P=0.001).In the dimension of natural acceptance,the scores of nursing students with religious beliefs were significantly lower than those of students without (t=2.52,P=0.012) ; the scores of nursing students who gained information of death from mass media were significantly higher than those of nursing students who never done so.(t=-3.85,P=0.000),which was the same in the dimension of approach acceptance (t=-3.48,P=0.001).Conclusions The majority of higher vocational nursing students can naturally accept death reality.Attitude of higher vocational nursing students toward death are influenced by physical and mental health,discussing death in family,family form,religious belief,suicidal thought and news or report about death from the mass media.

Objective: To optimize the pretreatment method of N-nitrosamine compounds in ready-to-eat aquatic products. Methods: Market-sold ready-to-eat aquatic products were collected, homogenized and distilled by steam. The samples were extracted for 10 minutes using dispersive liquid-liquid microextraction (DLLME) with ethanol, trichloromethane and sodium chloride (3.0 g). After centrifugation, the organic phase in the lower layer was collected and subjected to gas chromatography-tandem mass spectrometry (GC-MS/MS). The six common N-nitrosamine compounds were determined in ready-to-eat aquatic products using multiple reaction monitoring mode (MRM) and quantified by the internal standard method. Results: The optimized method exhibited a good linear relationship at concentrations of 10.0 to 500 μg/L for determination of 6 N-nitrosamine compounds (correlation coefficient of greater than 0.999), with 0.05 to 0.60 μg/kg limit of detection, 0.15 to 1.60 μg/kg limit of quantitation, mean spiked recovery rates of 71.8% to 108.9%, and relative standard deviations of 1.4% to 8.6%. N-Nitrosodimethylamine showed the highest detection rate in 20 market-sold ready-to-eat aquatic products (90%), and the detection rates of N-Nitrosopyrrolidine, N-Nitrosodiethylamine and N-dibutylnitrosamine were 15%, 10% and 10%, respectively. Conclusion Steam distillation combined with DLLME may optimize the pretreatment method of N-nitrosamine compounds in ready-to-eat aquatic products and meet the measurement requirements.

Determining the approach to spread the knowledge and technology for preventing birth defects using the diffusion of innovations theory.Identifying the target group,orientation messages and promotion guidelines based on related literature,laws and clinical epidemiology studies.Pathways integrating both inter-personal communication and IT have pushed the adoption percentage of innovative knowledge for preventing birth defects up from 0％ to 97 ％ in almost no time,helping the region ranking the first in China.The innovation diffusion model has caught attention of both the government and all the community.Prevention measures against birth defects are accepted community wide,while medical workers are regulated by law in their behaviors of mothers and children healthcare services to set a model for prevention of other diseases.

Objective To compare the effectiveness of controlling blood loss in the treatment of complex acetabular fracture between temporary occlusion of abdominal aorta by interventional balloon (TOAAIB),temporary occlusion of common iliac artery by interventional balloon (TOCAIIB) and internal iliac artery ligation (IIAL).Methods Included for this study were 113 complex acetabular fractures which had been treated at Department of Orthopaedic Trauma,Shaoguang Hospital Affiliated to Southern Medical University from January 2000 through January 2017.There were 68 males and 45 females,aged from 23 to 61 years (average,42.3 years).According to the Letournel classification,all of them belonged to complex fractures,including 10 T-type,24 double-column,16 posterior column & posterior wall,46 transverse & posterior wall and 15 anterior & posterior half-transverse ones.They were all treated by open reduction and internal fixation but differed in surgical hemostasis techniques:TOAAIB was used in 37cases,TOCAIIB in 31 and IIAL in 45.Fracture reduction was evaluated by Matta criteria.Intraoperative bleeding and postoperative wound drainage,fracture union and complications related to interventions were recorded.Hip function was evaluated by Modified d'Aubigne & Postal clinical grading system after fracture healing.Results The 3 groups (TOAAIB,TOCAIIB and IIAL) were comparable because there were no significant differences in gender,age,time from injury to surgery,Letournel classification or surgical approaches between the patients in the 3 groups (P ＞ 0.05).Anatomical reduction was achieved in 91.15％ of the patients (103/113) and satisfactory reduction in 8.85％ (10/113).Intraoperative hemorrhage was 1,631.5 ±675.5 mL in the HAL group,892.6 ±217.7 mL in the TOCAIIB group and 648.0 ± 170.2 mL in the TOAAIB group,showing significant differences between the 3 groups (P ＜ 0.05).One case of femoral artery thrombosis occurred in the TOAAIB group at the end of operation but was cured by symptomatic treatment of anticoagulation.There were no interventional complications in the other 2 groups.There were no significant differences between the 3 groups in postoperative wound drainage,fracture union time,hip function score or complications (P ＞ 0.05).Conclusions In controlling intraoperative bleeding in the surgery for complex acetabular fracture,TOAAIB may be the best,followed by TOCAIIB,and IIAL may be the worst.However,choice of a proper surgical hemostasis technique should also depend on the specific intraoperative condition of a specific patient.

Objective To investigate the feasibility of Region 4 Stork(R4S)project used for newborn screening by tandem mass spectrometry in China.Methods This retrospective study was performed among 362 822 neonates screened by tandem mass spectrometry from May 2015 to April 2016 in Zhejiang newborn screening center.Infants were grouped by screening result category: 83 true positive cases,360 554 true negative cases and 2 185 false positive cases.Raw data was uploaded into R4S website to perform postanalytical interpretive tools, then results were analyzed with interpretation rules.The comparisons of normal population percentiles were done at five selected percentiles between Zhejiang newborn screening center and R4S project with min-max normalization.Results Compared with cutoff system by using R4S project with interpretation rules,the positive predictive value increased from 3.7%to 8.3%,the specificity increased from 99.40%to 99.75%, and the false positive rate declined from 0.6% to 0.2%. The two cases of true positive hyperprolinemia were reported negative, and one case of β-ketothiolase deficiency was misdiagnosis.Totally 311 638 cases in true negative group were resolved by postanalytical interpretive tools,and the remaining 48 916 cases were excluded with interpretation rules.False positive cases were reduced to 897 cases.Results of percentiles comparison showed that levels of some markers were significantly different between zhejiang newborn screening center and R 4S project.Conclusions R4S project effectively improved the newborn screening performance, whereas leaded to a small number of misdiagnosis and missed diagnosis.Besides,many true negative cases should be excluded with interpretation rules.Optimization should be achieved based on local normal population.(Chin J Lab Med,2018,41:300-304)